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Gamunex-C
immune globulin (human)
Black Box Warnings .
Thrombosis
may occur w/ immune globulin products; risk factors incl. advanced age, prolonged immobilization, hypercoagulable conditions, venous or arterial thrombosis hx, estrogen use, indwelling central vascular catheter, hyperviscosity, and cardiovascular dz risk; thrombosis may occur in pts w/o risk factors; ensure adequate hydration before admin; give minimum dose at lowest infusion rate practicable in pts at risk; monitor for s/sx thrombosis and assess blood viscosity in pts w/ hyperviscosity risk
Renal Dysfxn/Acute Renal Failure
renal dysfxn, acute renal failure, osmotic nephrosis, and death reported w/ intravenous immune globulin (IVIG) use; pts predisposed to acute renal failure incl. those w/ pre-existing renal impairment, diabetes mellitus, volume depletion, sepsis, paraproteinemia, >65 yo, or receiving nephrotoxic drugs; ensure adequate hydration before admin; admin. IVIG at minimum dose and lowest infusion rate practicable in pts at risk; IVIG products containing sucrose as stabilizer accounted for disproportionate share of renal dysfxn/failure cases; this product does not contain sucrose
Adult Dosing .
Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing
primary immunodeficiency
- [IV route]
- Dose: 300-600 mg/kg/dose IV q3-4wk; Info: adjust dose based on trough IgG levels and clinical response; give 400 mg/kg/dose IV x1 ASAP if measles exposure; if maint. dose <400 mg/kg/dose IV q3-4wk and measles exposure risk, give 400 mg/kg/dose IV x1 just prior to exposure
- [SC route]
- Dose: weekly SCIG dose = [last IVIG dose (mg) x1.37] divided by last IVIG dosing interval (wk); Start: 1wk after receiving last IVIG dose; Info: adjust dose based on trough IgG levels and clinical response; consider additional dose if measles exposure; consider incr. maint. dose if measles exposure risk
idiopathic thrombocytopenic purpura
- [1000 mg/kg/dose IV x1 on day 1, may give additional dose x1 on subsequent day]
- Alt: 400 mg/kg/dose IV qd x5 days; Info: may repeat q3-4wk prn
chronic inflammatory demyelinating polyneuropathy
- [1000 mg/kg/dose IV q3wk]
- Start: 2000 mg/kg/total dose IV divided over 2-4 days, infused daily; Alt: 500 mg/kg/dose IV qd x2 days, given q3wk
secondary immunodeficiency, B-CLL assoc. (off-label)
- [400 mg/kg/dose IV q3-4wk]
myasthenia gravis (off-label)
- [400 mg/kg/dose IV qd x5 days]
- Max: 1000 mg/kg/day; Alt: 1000 mg/kg/dose IV qd x2 days
renal dosing
- [see below]
- renal impairment: not defined, caution advised; Info: use minimum dose and infusion rate practicable
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing
primary immunodeficiency
- [IV route]
- Dose: 300-600 mg/kg/dose IV q3-4wk; Info: adjust dose based on trough IgG levels and clinical response; give 400 mg/kg/dose IV x1 ASAP if measles exposure; if maint. dose <400 mg/kg/dose IV q3-4wk and measles exposure risk, give 400 mg/kg/dose IV x1 just prior to exposure
- [SC route, 2 yo and older]
- Dose: weekly SCIG dose = [last IVIG dose (mg) x1.37] divided by last IVIG dosing interval (wk); Start: 1wk after receiving last IVIG dose; Info: adjust dose based on trough IgG levels and clinical response; consider additional dose if measles exposure; consider incr. maint. dose if measles exposure risk
idiopathic thrombocytopenic purpura
- [800-1000 mg/kg/dose IV x1]
- Alt: 1000 mg/kg/dose IV qd x1-2 days or 400 mg/kg/dose IV qd x5 days; Info: may repeat q3-4wk prn
secondary immunodeficiency, B-CLL assoc. (off-label)
- [400 mg/kg/dose IV q3-4wk]
Kawasaki dz (off-label)
- [2000 mg/kg/dose IV x1]
- Start: w/in 7-10 days of dz onset; Info: give w/ aspirin; may consider repeat dose x1 if s/sx persist
renal dosing
- [see below]
- renal impairment: not defined, caution advised; Info: use minimum dose and infusion rate practicable
- HD/PD: not defined
hepatic dosing
- [not defined]